Ten Things You Need to Know about Bariatric Surgery

Michigan Bariatric Institute (MBI) offers a life-changing permanent weight loss experience with a multi-disciplinary team approach to care. With clinics and surgery centers at St. Mary Mercy Livonia and now St. Joseph Mercy Livingston, MBI’s team of fellowship-trained laparoscopic surgeons, registered dietitians, specially-trained nurses, behavior specialists and exercise physiologists are committed to guiding you through every aspect of the bariatric surgical process.

Bariatric surgeon, Mark Jonker, MD, shares some important insights in this Q&A for those considering bariatric surgery as a permanent weight loss solution.

As people are thinking about New Year’s resolutions and weight loss, what recommendations do you offer?
Weight loss is more than a “New Year’s resolution” and should be a year-round commitment. Make healthy lifestyles a priority by dedicating time to planning meals, eating healthy and exercising. Just as you would plan a vacation, plan your health choices. You should also speak with your primary care physician before beginning any exercise, diet regimen or nutrition program.

Weight management isn’t easy. Are diets and exercise the only options?
An appropriate diet and exercise is always the first step in achieving a healthy weight. Unfortunately, for many people, diets and exercise are not effective for long-term sustained weight loss. Bariatric surgery is a surgical weight loss option that both restricts someone’s ability to intake food and causes metabolic changes that aid in weight loss.

When should someone consider bariatric surgery?When diets and exercise do not work, bariatric surgery may be an option. In order to qualify for bariatric surgery, someone must have been unsuccessful in previous attempts at weight loss via diet and exercise, and have a body mass index of more than 40 (100 pounds over ideal body weight), or a body mass index of 35 (75 pounds over ideal body weight) with at least one medical obesity-related condition such as diabetes, high blood pressure or obstructive sleep apnea.

Are there more than one type of bariatric surgery?There are several types of bariatric surgery. However, currently, the laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are the most common. Your bariatric surgeon will discuss your weight loss goals and medical conditions and make a surgical recommendation that is most appropriate and effective for you.

How does bariatric surgery help someone lose weight?
With the two most common operations listed above, the stomach volume is smaller and results in restriction and a much quicker feeling of fullness. In addition, the changes in anatomy alter the expression of certain gastrointestinal hormones that affect hunger as well as metabolism.

How much weight does someone lose after surgery?Total weight loss varies by person and the type of surgery, however, the average weight loss with these operations is 70 percent of the person’s excess weight within the first one to two years after surgery. The overall success of bariatric surgery and long-term weight loss maintenance is also dependent on a permanent lifestyle change. Surgery should be viewed as the tool that allows for sustained significant weight loss, but not an easy fix.

How does weight loss surgery affect overall health?
In addition to sustained significant weight loss, bariatric surgery patients experience significant improvement or resolution of many obesity-related medical conditions. These include diabetes, obstructive sleep apnea, high blood pressure, arthritis and reflux disease. This can allow patients to come off of many medications and improve overall health and quality of life.

Is bariatric surgery a guarantee for permanent weight loss?
Almost all patients lose significant weight after bariatric surgery, but it is not a guarantee. While genetics and other factors may affect someone’s response to surgery, the most important determiner of success is a commitment to lifestyle change. Surgery is not an “easy way out” and requires dedication and compliance for optimal results.

What lifestyle changes are necessary after weight loss surgery?Each patient receives education as well as a comprehensive manual of appropriate and acceptable foods and beverages. Patients learn how to obtain the most benefit from the calories consumed by eating nutritious meals. Meals and snacks center on protein as the primary source of calories. Additionally, once a patient has recovered from surgery, patients will increase overall activity and develop a sustainable exercise program that fits his or her individual capabilities.

Does insurance cover bariatric surgery?In general, yes. However, many insurance companies consider bariatric surgery a special category and may or may not cover the procedure. Insurance companies often require documentation from your primary care physician detailing medical conditions, treatment plans and proof of unsuccessful weight loss attempts before covering the procedure. It is best to check with your insurance company regarding your coverage.

About Dr. Mark Jonker:
Dr. Jonker is board-certified in surgery by the American Board of Surgery. He completed a fellowship in minimally invasive and bariatric surgery at the University of Massachusetts Medical School in Worcester, Mass., and another fellowship in mucosal immunology and nutrition at the University of Wisconsin in Madison. He received his medical degree from the Medical College of Wisconsin in Milwaukee, and completed his residency at the University of Wisconsin Hospital and Clinics in Madison.